Índice de colapsabilidad de la vena cava inferior como predictor de hipotensión intraoperatoria

Abstract

Objective: To evaluate the lower vena cava Collapse Index (CI) as a predictor parameter of hypotensive episodes after general anesthesia induction in ASA I and II patients who were scheduled for elective surgery. Materials and Methods: A prospective, observational and simple blind study was designed. A sample of 80 patients was recruited. In the preoperative stage, they underwent protocolarized sedation and CI was obtained. Prior to induction, the baseline values of heart rate, non-invasive mean arterial pressure and continuous electrocardiographic tracing in DII were noted. In the post-orotracheal intubation stage, the aforementioned hemodynamic monitoring variables were recorded manually for 10 minutes. Results: The data of 78 individuals are presented. After anesthetic induction, 8 (10.3%) patients developed hypotension. The adjustment of the univariate logistic regression model for CI shows a good diagnostic capacity, with the area under the ROC curve equal to 0.76. The chance of presenting hypotension is increased by 62% by increasing the CI by 5 points (p = 0.003). Regarding the negative predictive value, we found that with values corresponding to the cutoff points between 39% and 46%, a probability of at least 93.1% of not presenting hypotension was obtained. The optimal cutoff point of the CI to predict hypotension is estimated at 43%, with a sensitivity of 62.5% and a specificity of 92.9%. Conclusion: A lower IC was associated with a lower probability of developing intraoperative hypotension. The use of this tool could be useful to anticipate which patients will be prone to intra-surgical hypotension.